Financing Long-Term Care in France

Like most industrialized countries, France is facing an ageing of its population which creates long-term care (LTC) needs and questions the financial coverage of LTC risks. In France, the public coverage of LTC derives from a long tradition of intervention concerning the Sécurité sociale (Social Security) and from a great diversity of stakeholders and sources of financing. At the national level, the public health insurance scheme deals with LTC expenses due to health care. In addition, the public pension scheme finances a significant part of living expenses. At the local level, local governments manage the Allocation Personnalisée d’Autonomie (APA). The APA is a public benefit allocated to people aged 60 or more, who are no longer able to care for themselves, regardless of their financial situation and place of residence. This allowance is jointly funded by central and local governments. APA can be seen as the first step towards recognition of dependency as a new risk of life, even if public coverage remains low in comparison with the financial expenses incurred by dependency.1 The French government, confronted by the complexity of financing LTC, is planning to reform the current system. A draft law is scheduled for discussion by the parliament during the second half of 2011.